PhilHealth observed that several benefit payment checks are still under the name of the deceased member and members who are outside of the country, hence, cannot be encashed and consequently had staled.
“It’s only when proper and valid documents to support a claim for check replacement that we can change the payee of the check”, explained by Roberto Dais, PhilHealth in-charge for check replacement, “without such, the check is generated on the member’s name.”
The problem usually happens on claims of deceased member, who died while confined or after discharged from the hospital but with pending claims because of previous hospitalization.
The check can be changed to the new payee but rightful claimant must first comply with the needed requirements such as the member’s death certificate as well as member-claimant proof of relationship.
Priority is given to those listed as dependents in the Member Data Record (MDR), from spouse to any of the child/ren authorized by the other siblings and biological parents. If member has no direct heir, a collateral relative may proceed to claim.
As to members who are abroad, check usually stales because their spouse cannot claim the same. “Common reason is, they alleged to have no joint accounts in bank wherein the check could be deposited, so they just await for the return of their member-spouse”, Dais added.
Under PhilHealth policy, benefit payment check is generally issued to the member. And only under two conditions: when payee is deceased or is out of the country, that replacement is allowed to the legitimate claimant.
A Special Power of Attorney granting authority to do PhilHealth transactions is one of the easy proofs. In its absence, the rightful claimant must submit a request and proof of member’s status abroad. Claimant has still to provide valid identification, IDs of both member and claimant. PhilHealth noted certain cases that spurious claimant faked the documents in order to claim.PhilHealth Regional Office VI head Alberto C. Manduriao stressed that members who understand their rights and complied their responsibilities do not find difficulty in processing and claiming PhilHealth benefits. So PhilHealth encourages members and dependents to be informed of these.